Dermatology Flashcards
The skin is composed of three basic layers:
Epidermis,
Dermis,
and Subcutaneous layers.
The epidermis is the most superficial layer of the skin, made up of keratinized epithelial tissue, and can be further subdivided into five layers, or strata:
stratum Corneum, stratum Lucidum, stratum Granulosum, stratum Spinosum, and stratum Basale.
The epidermal layer regulates __________ via the __________.
body temperature
autonomic nervous system
The subcutaneous layer functions to ________ and aid in __________.
insulate
temperature regulation
A change in blood flow can affect the skin’s appearance: a decrease in blood flow can cause ________, and an increase in blood flow can cause ________.
pallor
rubor
Macule or patch
A flat lesion <1cm that cannot be palpated (primary)
Papule
A solid elevated lesion or patch <1cm that can be felt (primary)
Nodule
A solid mass >5mm of depth, deeper than a papule, that can be felt (primary)
Plaque
An elevated, flat lesion >5mm in width (primary)
Vesicle
An elevated, clear fluid filled lesion <1cm in size (primary)
Bulla
An elevated, clear fluid filled lesion >1cm in size (primary)
Pustule
A raised lesion comprised of purulent material that may be white, yellow, or green (primary)
Cyst
Encapsulated epithelial lined cavity containing fluid (primary)
Erosion
Focal, incomplete loss of dermis (primary)
Ulcer
Focal, incomplete loss of dermis (primary)
Fissure
Crack in the skin, often narrow and deep (primary)
Wheal
Pruritic, erythematous elevated area resulting from dermal edema (primary)
Scale
Dry, plate-like mass of keratin tissue (thickened stratum corneum) (secondary)
Crust
Dried fluid or exudates (pus, blood, or serum) (secondary)
Lichenification
Thick, rough skin with accentuated skin markings (secondary)
Excoriation
Linear, traumatic lesion resulting in epidermal breakage (secondary)
Induration
Dermal thickening of the cutaneous surface (secondary)
Scar
Fibrous tissue that replaces normal tissue after healing (secondary)
Blisters (friction)
Repetitive shearing stress in horizontal direction produces friction, soft skin
Hot spot, superficial, clear liquid,
Blister, deeper tissue, blood
Talcum powder or petroleum jelly; double socks, second skin, moleskin, ice; WEAR CORRECT SIZE SHOES
Corns (friction)
Hard Corns
Caused by poor-fitting shoes or anatomical abnormalities such as hammer toes
On tops of hammer toes; appears hard and dry; sharply demarcated
Wear long enough shoes, small felt pad or sponge pad
Soft Corns
Caused by wearing narrow shoes and excessive foot perspiration
Pain lateral of the 5th toe, thick, white, macerated skin
Where wide enough shoes, keep skin dry, separate toes with cotton or lambs wool
Intertrigo/chafing (friction)
Skin rubbing against itself or equipment. Irritated or eroded skin. Should be cleansed with soap and water. Reduce friction and keep the skin clean and dry. Use powder or petroleum jelly as needed.
Acne Mechanica (friction)
Acne mechanica is a form of acne caused by heat, excessive pressure, and repetitive forces on the skin. Well-defined pustules and papules. Clean, dry uniforms will help reduce irritation and skin should be cleaned with soap and water immediately after activity.
What are the 5 wound classifications?
Laceration Abrasion Avulsion Puncture Contusion
Impetigo (bacterial infection)
Common, found in children; spreads rapidly in close contact such as wrestling
Mild itching and soreness, ruptured pustules/vesicles, honey-colored crusts
Thorough cleansing and application of topical antibacterial meds; systemic antibiotics are also appropriate
Erysipelas (bacterial infection)
Face and LE bacterial skin infection that starts with a friction injury and expresses as well-demarcated, indurated, edematous, erythematous plaque. Treated with antibiotics, such as penicillin, and elevated limbs.
Erythrasma (bacterial infection)
A skin infection caused by Corynebacterium minutissimum, a gram positive bacteria. It presents in skin folds as reddish-brown, pruritic, scaly plaques. Wood’s lamp, a diagnostic tool using ultraviolet (UV) light, will reveal the characteristic fluorescent coral red color of the organism. Referred to physician and topical antibiotics such as erythromycin, clarithromycin, or clindamycin.
Folliculitis (bacterial infection)
A blockage of the hair follicle, only extends to the epidermis. Resolves spontaneously or may require antibiotics. Rest from shaving.
Furuncles/carbuncles/abscess (bacterial infection)
More extensive than folliculitis, usually follows folliculitis. Erythematous, tender, pus-filled, elevated lesion. May include systemic sxs of fever or malaise. May be treated by warm water compresses. May require lancing and antibiotics.
Hot tub folliculitis (bacterial infection)
A gram negative rod. Acquired in hot tubs, whirlpools or swimming pools that are not treated appropriately. Clears up in a week. May require antibiotics.
Paronychia (bacterial infection)
Inflammation of the surrounding tissue of a nail. Treat with warm soaks with saline solution 2x daily. Topical antibacterials such as bacitracin (500 unit/g) or mupirocin 2% can be applied 2-3x daily. Antibiotics may be required, as well as incision and drainage.
Cellulitis (bacterial infection)
Infection of the skin that most typically occurs after there is a break in the skin. Presents with edematous, glossy-looking, erythematous tissue that is warm and painful to the touch. Systemic manifestation is common and includes fever, chills, malaise, and myalgia.
Acne Vulgaris (bacterial infection)
Inflamed hair follicles and sebaceous glands; severe acne that causes scarring
Whiteheads/blackheads, flesh- or red-colored papules, pustules, or cysts
Cleanliness c mild soap and warm water; topical and systemic meds; avoid over-treating; Accutane is effective but can cause birth defects so should be taken c contraceptive
Hydradenitis Suppurativa
Non-bacterial, needs to be differentiated from acne vulgaris. In males, the perianal and but- tock areas are more commonly involved and in females, the more commonly affected areas are axial and inguinal regions. Nodules can rupture and form an abscess and eventually drain purulent material. Physician treats with anti-androgens, antibiotics, and glucocorticoids.
Otitis Externa (swimmer’s ear)
Otitis externa can be caused by water polluted with the Pseudomonas bacteria. Scratching or sticking foreign objects in the ear can also lead to external otitis. Pain in the outer ear that increases when the clinician pulls on the ear.
Methicillin-resistant Staphylococcus Aureus (MRSA)
It is important to distinguish between hospital-acquired methicillin-resistant Staphylococcus aureus (HA-MRSA) and community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA). Transmission occurs from skin-to-skin contact in which infected athletes transfer the bacteria to another athlete. All athletes and facilities/equipment should be kept clean.
